Title:
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Characteristics of patients with hospital-acquired influenza A (H1N1)pdm09 virus admitted to the intensive care unit
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Author:
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Álvarez Lerma, Francisco; Marín Corral, Judith; Vilà Vilardell, Clara; Masclans Enviz, Joan Ramon; Loeches , I. M.; Barbadillo, Sandra; González de Molina, Francisco Javier; Rodríguez, Alejandro; H1N1 GETGAG/SEMICYUC Study Group
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Abstract:
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BACKGROUND: Influenza A (H1N1)pdm09 virus infection acquired in the hospital and in critically ill patients admitted to the intensive care unit (ICU) has been poorly characterized. AIM: To assess the clinical impact of hospital-acquired infection with influenza A (H1N1)pdm09 virus in critically ill patients. METHODS: Analysis of a prospective database of the Spanish registry (2009-2015) of patients with severe influenza A admitted to the ICU. Infection was defined as hospital-acquired when diagnosis and starting of treatment occurred from the seventh day of hospital stay with no suspicion on hospital admission, and community-acquired when diagnosis was established within the first 48 h of admission. FINDINGS: Of 2421 patients with influenza A (H1N1)pdm09 infection, 224 (9.3%) were classified as hospital-acquired and 1103 (45.6%) as community-acquired (remaining cases unclassified). Intra-ICU mortality was higher in the hospital-acquired group (32.9% vs 18.8%, P < 0.001). Independent factors associated with mortality were hospital-acquired influenza A (H1N1)pdm09 infection (odds ratio: 1.63; 95% confidence interval: 1.37-1.99), APACHE II score on ICU admission (1.09; 1.06-1.11), underlying haematological disease (3.19; 1.78-5.73), and need of extrarenal depuration techniques (4.20; 2.61-6.77) and mechanical ventilation (4.34; 2.62-7.21). CONCLUSION: Influenza A (H1N1)pdm09 infection acquired in the hospital is an independent factor for death in critically ill patients admitted to the ICU. |
Subject(s):
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-Infeccions nosocomials -Virus -Community-acquired infections -Critically ill -H1N1 subtype -Infuenza A virus -Mortality -Nosocomial infection |
Rights:
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© Elsevier http://dx.doi.org/10.1016/j.jhin.2016.12.017 . https://creativecommons.org/licenses/by-nc-nd/4.0/ |
Document type:
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Article Article - Published version |
Published by:
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Elsevier
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